Defining Electronic Health Record Standards for Child Health: A State-of-the-Art Review.

BACKGROUND: Improving child health using health information technology (IT) requires a unique set of functionalities that are built into the electronic health record (EHR) and are used to support patient care. In this article, we review and discuss the milestones preceding the development of a new child health EHR standard and describe the salient features of this contemporary standard. METHODS AND RESULTS: The Health Level Seven Pediatric Care Health IT Functional Profile (HL7 PCHIT FP) is an informative standard that encompasses the EHR functions required to care for patients less than 21 years of age in any clinical setting, developed to address the pediatric-specific functionality gaps in the EHR. It includes criteria that support communication between providers and all caregivers, inclusion of pediatric-specific vital signs and diagnosis, support for transition to adult care, and support for reporting and documentation of child abuse or neglect including communication with involved authorities. EHR functionalities for documentation and reporting of newborn screening tests with follow-up for abnormal results and functionality for children with special health care needs with support for identifying patients who may benefit from care coordination are also incorporated, in addition to school-based linkages enabling communication between the health care system and their school environment. CONCLUSION: The HL7 PCHIT FP is envisioned to be another vital step towards improving pediatric health by enhancing EHRs to address the unique health IT needs of children and their health providers. While the HL7 PCHIT FP is the most recently published standard on pediatric EHR systems, standards development is an iterative process, and recommendations for continuous refinement and additional functionalities for the next standards release are encouraged.

A scoping review on health records for child-in-care.

A scoping review was conducted to determine the current state of knowledge on child-in-care health records in academic literature. Eight studies describing five such health records were found. Different terms were found between countries. A key finding from the studies was that research needs to report on "what worked" to inform policy and practice for positive changes. Complete, accurate and consistent health records for child-in-care are needed that can support care and be aggregated to identify policy and practice gaps and interventions that were effective. Such health records enabled moving from reactive to proactive care for the child. Social work case data elements found in a child-in-care health record not included in a child personal health record include: court dates, dental, abuse, placement, and education. Including these data elements allows looking at the overall wellbeing and development of the child. With the exception of two, all studies reported positively on their implementation. Further, all studies advocated for continued development of a tailored child-in-care health record. The evidence points toward child-in-care health records as a tool toward achieving healthy outcomes and policy development.

A Descriptive Review: Six Pediatric Personal Health Records.

This descriptive review narratively synthesized themes and concepts from academic studies on pediatric personal health records (PHRs) from Medline EBSCO and CINAHL published January 1, 2007 to April 7, 2017. Reported features were summarized into a frequency table. Six studies in four countries reported PHRs for children with special health care needs, well-children, and adolescents. All studies advocated further development of such tools to improve healthcare. Such development might include children in the design phase.

Health Information Needs for Child-in-Care.

When a child is taken into care the State is legally required to provide healthcare. Six forms were reviewed by medical care providers, foster parents and government social workers to understand their health information needs in caring and planning for child-in-care. The qualitative study used a sociotechnical systems framework and NVivo 10 for encoding. Interview findings include that the forms, if completed and available, meet most basic health information needs with additional forms used for complex health needs. The majority of participants indicate interest in electronic options. Focus groups will enable further study.